Innovative Strategies in Motivational Interviewing for Substance Abuse Intervention with At-Risk Youth Michelle Coleman, LMSW, LCDC PH.D. Candidate
WARNING! • This is an INTERACTIVE SESSION! • YOU WILL BE ASKED TO PARTICIPATE! • YOU MAY BE APPREHENSIVE AND AMBIVALENT! • IT’s OK. We accept you AS YOU ARE • How willing are you to TAKE A RISK? • How ready are you to CHANGE?
AGENDA • Discuss motivational interviewing and strengths-based approaches for at-risk youth. • What works and doesn’t work according to current research and trends. • Develop curriculum and resources using hands-on interventions. • Current trends among youth in the Drug & Alcohol Field. • Conduct Practical Hands-On Exercises
Most successful National Employment and Vocational Training Program for At-Risk Youth. • Gary Job Corps in San Marcos, TX is located in central Texas between Austin and San Antonio and is the largest center currently serving over 1,085 students. • Offers vocational training in 18 vocational trades in 3 areas and 4 advanced training programs. • Current stats are: HSE 57.92% CTT 65.44% Combo 51.51% • Current graduate average wage is $9.86
Current Research on Youth • According to Botvin & Botvin (1997), social skills training in combination with other approaches has the most effective impact on substance use behavior. • The average brain isn’t developed until age 25. Therefore, due to adolescents unique developmental issues, differences in priorities, and susceptibility to peer influence, they must be approached differently from adults. • (Wormer & Davis, 2008).
Motivational Interviewing (MI) • Precontemplation • Contemplation • Preparation • Action • Maintenance • Relapse/Recycle • Prochaska & DiClemente (1992)
Practical Exercise • The Stages of Change Worksheet: • I refuse to participate • I don’t like to participate. • Unsure, Don’t know • I’m curious? • I love to participate! • How willing are you to Change? • On a Scale of 0 – 10, rate your readiness to change.
Current Research on Youth • What Doesn’t Work: • “If we’re encouraged to take a position, we become motivated to defend that position” (Aronson, 2002 p. 85). • Focusing on Addictive Behavior • Confrontation of Denial • Labeling or Blaming • The Question/Answer Game • The Expert Trap (opposite of collaboration)
Current Research on Youth • What Works: • A collaborative strengths-based approach. • Developing techniques for coping with cravings and urges. • Learning more adaptive methods for coping with life’s problems. • Using hands-on learning models vs. just teaching or talking. • (W.R. Miller & Rollnick, 1998)
Operational Concept Map:Road to Change Phase A – Initial Data Collection (Student Survey) Phase C – Program Implementation Phase B – Curriculum Overhaul Phase E – RALLY POINT! ADJUST TARGET…. Phase D – Follow Up Data Collection
Survey of Groups • 267 Pre Surveys • 382 Post Surveys were collected • Over the period of 6 months between May – Dec 2011 in order to determine: • Awareness of Zero Tolerance Policies • Identify participant attitudes and ambivalence • Establish a baseline upon program entry • Evaluate program impact and effectiveness. • Limitations of the Survey: • Validity based on self report • Pre-survey implemented after post-survey was initiated.
Intro to New Curriculum • “I will be open to change” • Week 1 – Intro. to Program and Stages of Change • Week 2 –Relationships and Coping Skills • Week 3 – Drug & Alcohol Abuse • Week 4 – Relapse Prevention • Week 5 – Wrapping It All Up • Week 6 – Mentoring Program
Eighteen Minutes • Teams of 4 • Tallest Freestanding Structure • Materials: • 20 sticks spaghetti • 1 yd. tape • 1 yd. string • 1 Marshmallow (ted.com)
Practical Exercise – Role Play • “You Broke The Law, You Be the Judge” • 1 Defendant • 1 Parent • 1 Judge • The Other Group Members are the Jury • You have 15 minutes to act out the case. • The judge may call on jury members for suggestions for interventions.
Practical Exercise – Risky Relationships • Draw a card from the Risky Relationships bag. • You are this character. • Go to Introduction and pick the corresponding color of the card for this character and read it to the group. • After each card, pick another group member that has not participated yet.
Practical Exercise – Temper Tamers • Each person draws a card • You must wait your turn • Read and discuss the card • Share only what you feel comfortable sharing. • Group members are encouraged to provide feedback.
What is your overall goal once you finish Job Corps and how does this relate to your success? n=267
Pre-Survey Comments: • “I think this program is good because I’ve always been punished for smoking (weed) but no one ever explained why it’s so bad.” • “I feel good because when you have a problem the first step is admitting it and then doing something about it and I am ready to change my problem.” • “It’s awesome to have a second chance”. • “I feel like I’ll benefit from the program, because what I was doing before wasn’t working.” • “Pissed off at myself that I couldn’t make this change sooner and hate the way this makes me look to the Job Corps.” • “It could save my life.” • “Very excited to take a change in my life and learn ways to be absolutely off drugs.”
Post-Survey Data n=382
How often do you attend? n=382
What do you like most? n=382
Post-Survey Comments • “The insightful board games, as you are able to interact and learn at the same time.” • “Talking to teachers and staff about drugs was helpful.” • “Every lesson made me wanna stop smoking (weed) even more.” • “The teachers were great at what they do.” • “I am thankful for this program. It really helped me find myself without drugs.” • “This has been an excellent program. Before I used to think that drugs made me feel better but now with the help of my peers and fellow instructors I see what matters in life. I hope to be able to mentor people and stop drug use and view the world the same way I now see it. I love this excellent and very beneficial program! Thank you!”
Leadership Skills • Appointment of a class leader • May rotate each week • Responsible for making sure students adhere to class rules and may assist instructor with group activities • Serve as a mentor to students struggling with issues related to recovery. • MODEL….MENTOR….MOTIVATE…….. INSPIRE CHANGE!
Practical Exercise – Leadership Skills • Each member draws a card • You must wait your turn • Read and discuss the card • Share only what you feel comfortable sharing. • Group members are encouraged to provide feedback.
Awards & Incentives • Request incentives for Awards for Completers • Announced in Orientation • Best Attendance • Best Participation • Most Improved Student • Best Leadership Skills • Be certain to stress follow up care
Resources for Curriculum • Marshmallow Challenge www.marshmallow.com • Adolescent Relapse Prevention Workbook www.relapse.org • Marijuana: Your Personal Recovery Plan www.hazelden.com • 100 Interactive Activities Book with CD www.therapeuticresources.com • The Coping Game www.therapeuticresources.com • Drug Prevention Bingo for Teens www.therapeuticresources.com • In the Know: Tobacco, Alcohol & Marijuana DVD www.prtpress.com • In the Know: Herbal Incense Fake Marijuana Pamphlet www.prtpress.com • Temper Tamers, Chill Skills, Leadership Skills in a Ja • www.freespirit.com
Resources for Curriculum • The Use, Relapse & Recovery Journey Game www.therapeuticresources.com • Risky Relationships-Teen Violence Simulation www.cafeprevention.com • They Broke the Law - You Be The Judge: Role Plays (FREE DOWNLOAD) http://www.freespirit.com/files/OTHER/They_Broke_the_Law_roleplays.pdf • The Marshmallow Challenge • http://marshmallowchallenge.com/Welcome.html
FREE Resources • Drug Free Worldhttp://www.drugfreeworld.org/ • Texas Alcohol Beverage Commission (TABC)http://www.tabc.state.tx.us/ • Mothers Against Drunk Drivers (MADD)http://www.madd.org • Above the Influencehttp://www.abovetheinfluence.com • National Institute on Drug Abuse (NIDA)http://www.drugabuse.gov/ • SAMHSAhttp://www.samhsa.gov/ • Motivational Interviewing Techniques:www.motivationalinterviewing.org
FREE Resources • Network with local colleges and universities and actively recruit Interns. • Become familiar with agencies and resources in your community you may be able to establish partnerships with: • United Way • American Red Cross • 12 Step Support Groups – NA & AA • Local State Troopers & Law Enforcement • Local Women’s Centers • HIV & AIDS Organizations • PROVIDE A HOLISTIC PREVENTION INTERVENTION MODEL FOCUSED ON RESILIENCE & A STRENGTHS PERSPECTIVE
References Beck, A. T., Wright, F. D. Newman, C. F. & Liese, B.S (1993). Cognitive Therapy of substance abuse. The Guilford Press. Botvin, G., & Botvin, E. (1997). School-based programs. J.H. Lowinson, P. Ruiz, R. Mulliman, & J.G. Langrod (Eds.), Substance abuse: A comprehensive textbook (pp. 764-775). Lawson, G, Lawson, A. & rivers, P. (2001). Essentials of chemical dependency counseling. (3rd ed.). Gaithersburg, MD: Aspen Publishers. Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing people to change addictive behavior. (2nd ed.) New York: Guilford Press. Wormer, K.V. & Davis, D. R. (2008). Addiction treatment: a strengths perspective. (2nd ed.) Belmont, CA: Brooks/Cole.
Contact Information Michelle R. Coleman, LMSW, LCDC TEAP Specialist Gary Job Corps 2800 Airport Hwy. 21 San Marcos, TX 78664 (512) 396-6416 email@example.com